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Survey Tracks Sustainability Progress in Healthcare

Health care food service programs are rapidly becoming more sustainable, following a conscious decision to provide fresher, more sustainable foods, says the 2011 Menu of Change report published by the Health Care Without Harm (HCWH) Healthy Food in Health Care (HFHC) program. It is the second in a series of reports tracking progress in this area and contains the results of a survey of U.S. hospitals and long-term care facilities that work with HCWH on implementation of sustainable food service practices.

"Many health care facilities are taking extraordinary and creative measures to make their food services more sustainable while providing fresh, nutritious food choices to patients, staff and visitors," says Emma Sirois, MS, Oregon HCWH program director and co-author of the new report. "The 2011 Menu of Change shows that many hospital food service programs are quite far along on their sustainability journey and those that are not as far along are advancing rapidly."

The survey was conducted this June and was designed to gather data on advances made in 2010. Eighty-nine facilities completed the survey, including many that have signed the HCWH Healthy Food in Health Care Pledge, a commitment to work in a stepwise fashion to source more local and sustainably produced food among other activities.

Facilities ranged in size from 11 to 1200 beds with an average of 300. They served an average of 731 patient meals and 1650 cafeteria meals per day in 2010 and spent approximately $291 million total on food and beverages.

Some 2011 Menu of Change Survey Highlights...

Nutrition. Most respondents have taken one or more of the following steps to increase their offerings of fruits and vegetables and nutritionally dense and minimally processed, unrefined foods and to reduce unhealthy (trans and saturated) fats and sweetened foods

• 97% adapted menus to include non-starch vegetable options for lunch and dinner and provide a minimum of one protein-balanced vegetarian menu option during each meal

• 87.5 percent have completely eliminated trans-fats (partially hydrogenated/fully hydrogenated) and created a heart-healthy oils purchasing policy

• 80.5 percent create soup from scratch

• 74.7 percent serve fresh local produce when available

Sustainable food procurement. Many facilities are choosing to purchase and serve more locally sourced and sustainably produced food and beverages

• 94.1 percent purchased and served local food or beverages

• 80 percent purchased sustainable dairy products

• 45 percent purchased sustainable beef

• 36 percent purchased sustainable chicken

Build direct relationships with local farms

• 81.8 percent of respondents host a farmers' market, farm stand or community-supported agriculture (CSA program on-site)

• 60 percent purchased directly from a farm, ranch or farm cooperative

Waste Reduction

• 66.2 percent of respondents used bio-based non-reusable food service ware and takeout containers

• 50 percent use a room service model for patient food delivery

• 39.5 percent had a program in place to compost organic materials (food waste and compostable paper and plastic food ware items)

• 37.7 percent had a usable food donation program in place

"This Menu of Change report is an excellent introduction for anyone seeking to begin a sustainable foods program at their hospital," says Marie Kulick, MSEL, HFHC Sustainable Procurement advisor and report co-author. "In addition to the survey data which can be used to set goals, the report includes lively, informative anecdotes from peers, cost cutting strategies, profiles of leading institutions and more."

The 2011 Menu of Change report also summarizes major HFHC activities taking place in nine states and describes the HFHC initiatives, including Balanced Menus, Non-Therapeutic Use of Antibiotics Prevention, the HFHC Pledge, the Green Guide for Health Care Food Service Toolkit, and recent efforts to reduce or eliminate Sugar-Sweetened Beverages, among other initiatives promoted by the HCWH. It also contains a listing of contacts for hospital and food service directors or activists to reach out to HFHC program staff for assistance.

"Hospitals are increasingly being seen as anchor institutions that are needed to support healthier communities and a healthier local economy," says HCWH President Gary Cohen. "If we are to solve the epidemic and escalating costs of obesity in American society, hospitals need to be critical partners in redesigning sustainable food systems and modeling the kind of food choices that the rest of us need to adopt. The Healthy Food Program is creating these models and pointing the way toward this systemic transformation."

For more information about the HCWH Healthy Food in Health Care Program, visit

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